| NPI | 1730577115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOPAL R KORUPOLU Physician/Owner 352-799-3449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME0070951) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-02-10 |